the shizzle > diet, training and injuries
Full tear rotator cuff.
sheavi:
Hi
I'd take Duncan's advice and certainly note Matt's experience. I've seen many patients post repair (months/years after) and the results are mixed. Also re-tears post-surgery are quite common but appear not to cause symptoms necessarily. Far more important than any scan is how your function is. If you can boulder without pain except slapping - then perhaps surgery is unnecessary at present. Instead a structured course of rehabilitation is first required. No doubt surgery does have its place and many people report positive outcomes. The sceptic in me does wonder if that is always to do directly with the surgery or perhaps the time spent afterwards in rest and rehabilitation, not the mention the powerful effect of expectations/mind/placebo etc. that surgery can bring.
You mention that perhaps the bursa may be the source of symptoms which is touched on in the first link below.
Here's some links that may be useful.
https://www.thesports.physio/rotator-cuff-tears-cables-and-crescents/
https://www.thesports.physio/a-hole-in-the-blanket/
Good luck.
Oldmanmatt:
--- Quote from: duncan on March 23, 2024, 07:41:25 pm ---
This sounds like the classic 'strong but slow' muscles. Like being able to hang big weights off a 20mm edge but lacking contact strength. Do you do any work that encourages speed of 'switching on' unpredictably? Throwing and catching? Crawling on all fours?
--- End quote ---
This sounds like me… Strong but old and slow.
Short answer is no to not enough. I keep trying, but I’m prone to pushing too hard too quickly. I tried to take up TKD again, since I have a Dan grade mate here, who I trained with a couple of decades ago. I could keep up with the classes, but ended up injured again (MCL, recurrence). Again, not lacking power, but too slow to think about taking it seriously again. I have good flexibility, yet strangely restricted mobility. I perform well in floor exercises, and flexibility tests, then can’t get my legs up to kick or high step when climbing. So many old injuries that I can tweak or irritate, including a few I thought well and truly rehabbed. I can go run 10k through the desert carrying a 10-15kg bergan, do all kinds of tricks on a bar or rings, jump press ups on my knuckles, hang a 6mm edge; but I can’t pull for shit when actually climbing or twist and turn my body as I know I should. I know I have to start taking movement training seriously, but find it hard to motivate myself.
If I’m honest, I’m an old man who used to be able to do so much, quite easily/naturally and is sulking about time’s increasing limitations on that ease. I will snap out of it, I usually do.
Ru:
I have a family member that has potentially torn their rotator cuff, probably the supraspinatus. Could anyone help me understand the terminology and anatomy?
My previous understanding was that the supraspinatus muscle attached to the humeral head via a tendon that could have a partial thickness or full thickness tear. I have read that a full thickness tear is one that goes all the way through the tendon. My lay understanding of this was that the tendon is like a rope and so a full thickness tear would be like completely severing a rope - i.e. there would be nothing holding the muscle onto the bone. The muscle would then retract like the bicep does when the long head bicep tendon is completely ruptured.
However, I have then read that a full thickness tear is like a "hole" that goes all the way through. The description of a "hole" in a tendon I find very confusing, as you wouldn't describe a completely severed rope as having a "hole" in it. I have also read that the hole would be like a hole in a sheet - this gives me a mental picture of a flatter structure that is compromised, but the tendon around the hole is still intact.
So basically I have no real mental picture of what a full thickness tear is. If the supraspinatus muscle is completely detached that would seem to me to be a strong argument for surgery, but if the muscle is still functioning and attached, but compromised, that would seem to be a good reason to try to strengthen what's left initially. I doesn't help that different sources use terms interchangeably, resulting in terms like "full thickness partial tears", whereas other sources use "partial tear" to mean "not full thickness."
sheavi:
--- Quote from: Ru on March 24, 2024, 05:14:27 pm ---I have a family member that has potentially torn their rotator cuff, probably the supraspinatus. Could anyone help me understand the terminology and anatomy?
My previous understanding was that the supraspinatus muscle attached to the humeral head via a tendon that could have a partial thickness or full thickness tear. I have read that a full thickness tear is one that goes all the way through the tendon. My lay understanding of this was that the tendon is like a rope and so a full thickness tear would be like completely severing a rope - i.e. there would be nothing holding the muscle onto the bone. The muscle would then retract like the bicep does when the long head bicep tendon is completely ruptured.
However, I have then read that a full thickness tear is like a "hole" that goes all the way through. The description of a "hole" in a tendon I find very confusing, as you wouldn't describe a completely severed rope as having a "hole" in it. I have also read that the hole would be like a hole in a sheet - this gives me a mental picture of a flatter structure that is compromised, but the tendon around the hole is still intact.
So basically I have no real mental picture of what a full thickness tear is. If the supraspinatus muscle is completely detached that would seem to me to be a strong argument for surgery, but if the muscle is still functioning and attached, but compromised, that would seem to be a good reason to try to strengthen what's left initially. I doesn't help that different sources use terms interchangeably, resulting in terms like "full thickness partial tears", whereas other sources use "partial tear" to mean "not full thickness."
--- End quote ---
I'll have a go! Tendons come in different shapes and sizes. An achilles tendon is more rope-like but rotator cuff tendons are much flatter and more analogous to perhaps a bicycle inner tube or thicker cloth. A partial tear is like a hole/fissure that doesn't go all the way through, where a full thickness tear does. A full thickness tear can sometimes mean it has detached from the bone but this is usually called a rupture. I hope that makes sense.
https://www.thesports.physio/a-hole-in-the-blanket/
mrjonathanr:
--- Quote from: Ru on March 24, 2024, 05:14:27 pm ---. I have also read that the hole would be like a hole in a sheet - this gives me a mental picture of a flatter structure that is compromised, but the tendon around the hole is still intact.
--- End quote ---
Like you, I’m a layman, but that describes my understanding of it. I’m told the supraspinatus tendon is roughly flat, not round.
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